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Fall 2008 | Spring 2009

CHIP Fall '09

Contact Information

Department of Physics
525 Northwestern Avenue
West Lafayette, IN
47907-2036

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Telephone:
(765) 494-2970
Fax:
(765) 494-0706

REU Online Application

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Personal Information

First Name:* Middle Initial: Last Name (family):*

Current Contact Information (School Address)*

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Your email:*

Permanent Contact Information (Home Address)*

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Educational Information

*Your current college/university/institute:
*Expected Graduation Date: Month Day Year
*Major field of study: *GPA (based on A=4.0):

Previous colleges or universities attended:

1st college attended
2nd college attended

Academic and career objectives

Honors, awards, recognitions

Research Experience

(Practical experience in research laboratories, academic instructional labs, electronics, computer interfacing, automotive repair, construction, design, etc.)

Research Activities	Location	Dates of Activity
Research Activity 1	Activity Location 1	Date of Activity 1
Research Activity 2	Activity Location 2	Date of Activity 2
Research Activity 3	Activity Location 3	Date of Activity 3
Research Activity 4	Activity Location 4	Date of Activity 4
Research Activity 5	Activity Location 5	Date of Activity 5

Recent Work Experience

Employer	Location	Dates of Activity
Employer 1	Employer Location 1	Date of Activity 1
Employer 2	Employer Location 2	Date of Activity 2
Employer 3	Employer Location 3	Date of Activity 3

Computer Experience

Please describe your level of computer skills.

REU Goals

Specific area of interest for REU program, if strong preference exists:

Citizenship Requirement

NOTE: A participant must be a citizen or a permanent resident of the United States. Clicking the box below certifies that you meet this requirement.
YES, I meet the United States citizen/permanent resident requirement.

Department of Physics